๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Granulation
Granulation
Allowing a defect to heal by secondary intention is a useful option for many locations on the hand and foot. Due to the highly vascularized nature of the soft tissues in the hand, secondary intention healing maybe highly effective. Small defects in virtually any location of the hand or foot can heal well by granulation. Even large wounds, in certain locations, can heal very well without significant scarring or contraction (Fig. 45-9).40,41 Occasionally, patient factors such as diabetes, and poor arterial or venous circulation, can lead to prolonged healing of a granulating wound, especially below the knee. A retrospective review of secondary intention healing after excision of acral lentiginous melanoma on the foot showed slower healing with granulating wounds as compared to full-thickness skin grafts, but improved cosmetic and functional outcomes over skin
grafting.42
Figure 45-9. (A) Finger defect healed by granulation. (B) Result at 6 months.